Matt dives into a specific healthcare topic to help those in the industry, and those outside of it, better understand the market drivers causing today’s healthcare challenges.

Stop and look at who signed. The American Heart Association. The ALS Association. Susan G. Komen. The American Cancer Society Cancer Action Network. The National Health Council. Forty-three more. These organizations spend every other week of the year competing for the same philanthropic dollars and the same patient attention. They guard their brands like assets, because their brands are assets. Then they set the competition down and signed together, because the interim final rule for Public Law 119-21 threatens the patients all of them serve.

Groups that protective do not co-sign lightly. When they do, the people who track power in Washington notice. The signature carried weight precisely because these organizations almost never stand in one line. A coalition of rivals reads as a warning that a single trade association never could. That is the lesson the commercial side keeps missing. The advocacy community speaks loudest when it speaks together, and it decides who it stands beside long before the statement goes out.

The rule earns the alarm. The interim final rule redefines the medical frailty exemption to cover only people who can prove they cannot work, and it strips states of the ability to accept patient self-attestation starting in 2028. The coalition warned that the rule pushes people with serious and complex conditions off coverage right as the January 2027 deadline hits. Read that timeline. States lose a tool they counted on, patients face a higher bar, and the clock runs out in the same window.

ELAVAY Advocacy Intelligence data tells the same story from the commercial side. The advocacy organizations that pharma and biotech depend on for patient trust carry measurable influence, and the companies that score highest with them treat advocacy as strategy rather than charity - they recognize that annually, advocacy impacts the bottom line at ~$4 million per asset. The BIOADVOCATE Benchmark exposes the gap in how companies value their own advocacy and professional society relationships and the execution of that work by their own functions. That gap is where access strategies quietly fail.

Picture the company that believes it owns a strong relationship with a major patient organization. The internal scorecard looks great. Then a coalition forms, the statement goes out, and that company's name appears on no one's call list. The benchmark predicted that outcome months earlier. The company just chose not to read it. They chose to bury their head in the sand as the patient community outpaced their company’s progress in representing patients.

Most commercial teams still file advocacy under corporate giving. They fund a walk, slap a logo on a slide, and call the relationship managed. The check clears, the photo goes up, and the patient's voice never reaches the room where the access strategy gets set.

Some companies route advocacy through communications instead of market access. That structure guarantees the failure. Communications protects the brand. Market access decides who gets the drug. When you bury the patient voice inside the function that worries about messaging, you cut it off from the function that controls coverage. The org chart itself silences the people you claim to serve while chalking advocacy strategy up to “Feel Good Friday’s.”

So when forty-eight organizations mobilize against a federal rule, the companies treating advocacy as a charity line sit on the outside. No seat. No signal. No early read on a fight that will reshape access for millions of their own patients. They learn about the coalition from a press release, the same way the public does, and by then, the relationship that would have given them a voice has already passed them by.

The ELAVAY top-tier companies run advocacy as a strategic function. It carries a budget, a seat at the commercial table, and an external benchmark the team actually reads. These companies show up before they need something. They earn the relationship in the quiet years, long before any rule drops, before a drug is being discussed by CMS or the FDA, and long before any coalition forms.

They measure what matters. Trust. Responsiveness. Commitment to patient outcomes. Corporate reputation. The needs of the patient community. They read what the data exposes, then they fix it instead of explaining it away. A weak score becomes a project, not a slide they bury. So when a coalition does form, the community already knows where these companies stand, because the companies put in the work when nothing forced them to.

I built Archo on a simple read of this industry. The relationships you neglect in the calm seasons disappear in the storm. The top performers never test that the hard way. They treat the quiet years as the entire game, because the loud years only reward the companies that already did the work.

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Stop solely funding advocacy and start respecting it. Pull your advocacy function out of the giving column and put it where access strategy lives. A walk and a logo buy you goodwill for an afternoon. A seat at the access table buys you the patient voice when the next rule threatens coverage.

Then measure where you actually stand with the community before the next coalition forms without you. The 2026 ELAVAY report shows you exactly that. To access this year's report, email [email protected]. Or take the free Advocacy Influence Diagnostic at https://aid.elavay.com and see how much internal influence your advocacy function really holds.

Join us for an exclusive webinar where we explore how leading pharmaceutical and biotech companies use Advocacy Intelligence to strengthen partnerships, improve patient outcomes, and drive measurable impact. Register at webinar.ELAVAY.com. Or email [email protected] directly with any questions.

Forty-eight rivals signed one page and moved Washington. Ask yourself one question before the next coalition forms. Will the community put your company on the call list, or will you read about the fight after it ends.